Accident / Incident Report
Document any on-set injury, near miss, or property damage — the safety record.
Who It's For
- 1st ADs, UPMs, and safety officers.
- Anyone who witnesses an on-set incident.
- Productions maintaining a safety record.
What It's For
- Records what happened, when, and to whom.
- Logs first aid, witnesses, and who was notified.
- Captures corrective action and sign-off.
Incident
People
Description
Witnesses
Follow-Up
Sign-Off
Filmmaker Genius — Document Library.
Accident / Incident Report
Production: [Production Name]
Date: [Date]
Time: [Time]
Location: [Location]
Incident Type: Injury
People
Person(s) Involved: [Person(s) Involved]
Role / Department: [Role / Department]
Reported By: [Reported By]
What Happened
[What Happened]
Injury / Damage Description
[Injury / Damage Description]
First Aid / Medical Response
[First Aid / Medical Response]
Medical Attention: None
Witnesses
[Witnesses]
Reported To (UPM / Safety Officer)
[Reported To (UPM / Safety Officer)]
Corrective Action
[Corrective Action]
Reporter
Signature: _______________________
Print: [Reporter (print)]
Date: _______________
Supervisor
Signature: _______________________
Print: [Supervisor (print)]
Date: _______________